The Dartmouth Atlas Project is basically a text in which medicine and it's many variations are described. It keeps track of differences in treatment and cost of healthcare and focuses on various specific communities. This project involved the studying of medical records such as billing and it was discovered that the amount of treatments and the amount of money spent in each community were not across the board. Certain communities were much more cost efficient. However, it was not a result of less patients or the general financial status of patients in these areas. Cost efficiency in these communities arose from a larger number of provided services. For example, if an area had a large number of doctors, more treatments would occur than were necessary at times, either because the patient didn't need or want them, but still needed to be paid for.
It's my personal opinion that all individuals should have equal rights to health care, simply because each individual has the right to be healthy and a right to life. Healthcare is a right. Those with more access to money should not be privileged in terms of their health and life; rather, we should all be given that privilege and it should be treated as a right. If we are all equal according to the U.S. Constitution, then health care should be a standard thing for everyone. There should be a minimum amount of health care that is available to all, and extra healthcare beyond that point should be something that can be bought. The problem is that it's difficult to decide where to draw the line- what is the minimum amount of healthcare that each person deserves? Healthy people are less expensive than sick people. Equal and widespread healthcare would eventually be beneficial to the system in addition to simply the individuals being treated.
On the program, several medical systems were visited, including Grand Junction, Seattle, Everett and Autumn (New Hampshire). Many innovations came out of these medical systems.
For example, one such innovation implemented in Grand Junction was particularly interesting to me. A doctor opted to receive the same amount of money from each patient if they required the same amount and kind of care. This idea developed further into what is called the Independent Practice Association, or IPA. This way, doctors had no problem treating patients of lower financial status because they didn't lose anything by doing so. I found to to be interesting in a positive way because quite often doctors have a reputation of being profit-oriented and selfish. However, this innovation in Grand Junction shows a different side to doctors.
In Seattle, the innovation that I found to be most interesting was called Group Health. It's a very modern system in that it consisted of electronic medical records. This way, both the doctor and the patient are able to access the same information in the same way and there is less distance between the doctor and patient, as well as less ignorance on the end of the patient. What struck me most was that this innovation led to an increase in virtual medical treatment! For example, doctors began interacting with and treating their patients over e-mail. This way, visits to the doctor were not always as necessary as they had been, saving time and energy for both the doctor and patient. My own father is a pediatrician, and sometimes his appointments with patients occur over a web-camera with his patients, but this is only a recent thing that has begun. Group health is a very patient-oriented system in that it allows for maximum care for the patient. Since doctors are paid a salary, they are able to spend more time with each individual patient throughout the day and treat them more carefully.
In Everett, the most important innovation involved ending the number of unnecessary treatments that take place and thus creating cost efficiency. This way, patients wouldn't be getting MRI's unless questions asked beforehand revealed for sure that it was something they truly needed or qualified for. I thought this was a really good idea, because medical services aren't something that should be used or wasted when they aren't necessary.
Finally, in New Hampshire, I found it to be a very positive thing that shared decision making is taking place. In this system, the patient has more of a say in terms of their own treatment. They are educated about their entire situation and have the freedom to choose which treatment they would prefer after being made aware of the pros and cons of each. By giving this freedom to the patient, doctors become less like figures of power and authority and their relationship with their patients is probably better and one full of trust, which is very important.
These innovations can easily be re-created and spread. However, this probably hasn't happen due to a lack of communication in between medical communities and a lack of leaders who are willing to take charge and initiate change in the first place. If medical communities adopted new things from one another and communicated more, perhaps at several annual conferences in which they share their innovations, these innovations would be spread more easily. We'd also need individuals in each community to take control and be the one to organize everyone together and implement these innovations at a systematic level. Once this leader has a group of people behind them, the process would expedite.
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